I’m pleased to be able to introduce Stewart Gregory of Browne Jacobson. Stewart is head of the property health team with over 12 years of experience in NHS property work. He is recognised as a leading individual in health property law for his work on major property based projects, including NHS LIFT and property development schemes in partnership with local authorities. He has recently advised clients on primary care development schemes through both the self-funding and 3PD routes.
In the Chancellors Autumn Statement he announced that a total of £1bn was being invested into primary care facilities (that is in addition to a £200m transformation fund to support the creation of new models of care as required by the Five Year Forward View). In December of last year the Health Secretary advised that GP practices would be encouraged to join up closely with local job centres, social services and other community services, in order to ensure that the NHS is also supporting people back into the labour market in return for the £1bn funding.
Last week the Health Secretary confirmed that a letter is to be sent to every GP practice inviting them to bid for some of that funding. Mr Hunts statement confirmed that practices would be able to bid for the first tranche of the funding with the aim of supporting more GP appointments and more proactive care for the most vulnerable.
Whilst the announcement of additional funding for practice premises has been welcomed, there are still many voices of concern as to how practices will benefit from the funding. For some time the GPC has been stressing the essential and urgent need to invest in general practice premises. However, the funding that has been announced is considered to be only a fraction of what is really needed and it does of course come with significant conditions attached.
The headlines are about funding for GP premises. However, there is concern that the proposals dont really address the need for investment in premises to make the current estate fit for purpose but instead only provide a fund for those practices willing and able to offer enhanced services.
Indeed, Mr Hunts December 14 statement refers to the bringing together of GPs, nurses and specialists with the fund paying for modern premises and technology that will give patients access to advanced care, such as chemotherapy and dialysis, in their local communities. In announcing the investment, NHS England last week also said that GPs bidding for the funding will need to set out how [improved] premises will give them the capacity to do more; provide value for money; improvements in access and services for the frail and elderly.
These concerns are put in context when we consider that a recent BMA survey suggested that four out of ten practices in England felt that their facilities were struggling to provide even basic care. However, we should not lose sight of the fact that £250m of additional funding is to be provided over each of the next four years and that is substantial investment. There is no doubt that this level of investment, delivered properly, could really help to address current issues with the primary care estate.
Bids for investment in 2015/16 have to be submitted to NHS England by 16th February. An application form and details of the funding can be found on NHS Englands website at: https://www.england.nhs.uk/commissioning/primary-care-comm/infrastructure-fund/. The letter inviting bids for the funding confirms that the key metrics for prioritisation will be:
- Access to general practice (including increased appointment and patient contact time) and/or
- Enhanced services to support patients manage their conditions in community settings, with a measurable reduction in emergency attendances or admissions to hospital for those over 75.
Bids will also be prioritised based on:
- Clear identified need
- Value for money
- Extent to which the scheme supports the longer-term strategic direction for the local health and care system
- Ability to work with wider public services
- Deliverability in 2015/16
- Longer term sustainability
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